go back

New York rates for HCPCS 0264T

Intramuscular autologous bone marrow cell therapy, with preparation of harvested cells, multiple injections, one leg, including ultrasound guidance, if performed; complete procedure excluding bone marrow harvest

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,819.70 / $5,370.32 / $10,964.78
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.18 / $134.90 / $177.83
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,073.80 / $7,762.47 / $13,803.84
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$117.49 / $144.54 / $363.08
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$204.17 / $204.17 / $16,595.87
CDPHP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$204.17 / $204.17 / $204.17
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$275.42 / $275.42 / $53,703.18
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$776.25 / $776.25 / $776.25
Excellus BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$151.36 / $213.80 / $407.38
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50,118.72 / $53,703.18 / $75,857.76
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,398.83 / $5,888.44 / $13,489.63
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.90 / $194.98 / $457.09
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$120.23 / $154.88 / $154.88
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.25 / $154.88 / $371.54